Stem cell donor. Bone marrow donation: sampling procedure, types and possible consequences. How material is taken

"Become a bone marrow donor - save a life." Such an inscription looks at people from a billboard on the streets of Moscow, someone seems to want to help, but knows nothing about either the bone marrow itself or how it will be taken away. We are looking into this together with the hematologist at the K + 31 clinic, Marina Fainberg.

What is bone marrow

The bone marrow is a soft tissue of the internal cavity of the bone, where in humans there is hematopoiesis (the maturation of blood cells, hematopoiesis). In humans, the bone marrow makes up an average of 4% of body weight. Distinguish between red and yellow bone marrow. Red (active) bone marrow is a myeloid tissue that consists of two main components: stromal (stroma serving as a microenvironment for hematopoietic cells) and hemal (blood cells at different stages of development). Yellow (inactive) bone marrow is adipose tissue. It is located in the medullary canals of tubular bones.

Bone marrow hematopoietic stem cell transplantation (bone marrow transplantation) is a medical procedure used in hematology and oncology, in diseases of the blood and bone marrow, as well as some other malignant diseases.

Depending on the source of hematopoietic cells, there are:

autologous transplantation (pre-prepared cells obtained from the patient);
allogeneic transplantation (from a donor, including relatives).

Who can become a bone marrow donor

The selection of a bone marrow donor for a particular patient is a very complicated procedure, which is performed on the principle of tissue compatibility between the donor and the recipient. The coincidence of blood groups according to the AB0 system is optional. The greatest chance of finding a donor is to examine the patient's siblings: the probability of complete compatibility with a brother or sister is 25%. If there are no siblings suitable for donation, unrelated bone marrow donors will have to be sought.

Any capable person aged 18 to 55 who has never had hepatitis B or C, tuberculosis, malaria, malignant diseases, mental disorders, is not a carrier of HIV and meets some other requirements can become a potential bone marrow donor.

In order to become a potential bone marrow donor (to be enrolled in the registry), you need to undergo HLA typing at one of the centers providing this service. The procedure consists in taking 5-10 milliliters of blood from a vein. If you are eligible as a potential donor for any patient, another 10 ml sample of your blood will be required to ensure that you are compatible with the patient. If the compatibility is confirmed, you will immediately be informed about the methods of bone marrow or peripheral hematopoietic stem cells collection and the preferred method for a particular patient.

How is bone marrow taken from a donor?

Thanks to the use of drugs that stimulate the release of bone marrow cells into the peripheral blood, it is possible to avoid taking bone marrow from a donor. In this case, blood is taken from a vein and subjected to apheresis, as a result, the cells necessary for the recipient (patient) are removed, and the blood itself is returned to the donor's body. Externally, the procedure is similar to hemodialysis. Then the patient is injected intravenously with a suspension of donor hematopoietic cells, which gradually populate his bone marrow from the bloodstream and restore hematopoiesis.

If bone marrow cells are taken from the donor for transplantation, and not peripheral blood cells, then the donor is hospitalized in the clinic for one day. The bone marrow sampling procedure is performed under general anesthesia. Bone marrow is taken from the pelvic bones with special needles with a wide lumen. The procedure lasts up to two hours, during which no more than 5% of the total volume of the donor's bone marrow is taken. As a rule, on the evening of the day of the operation, the donor can leave the clinic for home. For several days, soreness is allowed - as after a blow from a fall. Common painkillers help. Complete restoration of the bone marrow in the donor occurs within two weeks.

In the human body, red bone marrow performs the function of blood renewal. Violations of his work entail serious diseases, the number of which is constantly growing. So there is a need for a transplant of this element of the body's system, which creates a demand for donors. The difficulty of the situation becomes finding the right person.

Types of bone marrow transplant

Previously, this procedure was not performed, but bone marrow is now being transplanted to treat or improve survival in leukemia (blood cancer), lymphoma, aplastic anemia, multiple myeloma, breast cancer, ovarian cancer. The main task of the donor is to donate hematopoietic stem cells, which become precursors in the formation of all other components of the blood. For their transplantation, there are two main types of procedures - allogeneic and autologous transplantation.

Allogeneic transplant

This type involves the sampling of bone marrow from a person that is as close as possible genetically to the patient. As a rule, they become a relative. This donor transplant option can be of two types:

Syngeneic - derived from an identical twin. Autotransplantation of the bone marrow from such a donor implies full (absolute) compatibility, which eliminates the immune conflict.
In the second case, a healthy relative becomes a donor. Efficiency directly depends on the percentage of compatibility of bone marrow tissues. A 100% match is considered ideal, and with a low percentage, there is a chance that the body will reject the transplant, which is perceived by it as a tumor cell. In the same form, there is a haploidentical transplantation, in which the match has 50% and is carried out from a person with an unrelated relationship. These are the most unfortunate conditions that have a high risk of complications.

autologous

This procedure consists in the fact that pre-harvested healthy stem cells are frozen and planted in the patient after high-intensity chemotherapy. With a successful procedure, a person quickly restores the body's immune system, the process of hematopoiesis normalizes. This type of transplantation is indicated in case of remission of the disease or when the disease does not affect the bone marrow:

with a brain tumor;
ovarian cancer, breast cancer;
lymphogranulomatosis;
non-Hodgkin's lymphoma.

How to become a donor

In order to be included in the bone marrow donor registry, a person must be 18-50 years old. Other requirements: no hepatitis C and B, malaria, tuberculosis, HIV, cancer, diabetes. To be entered into the database, you must donate 9 ml of blood for typing, provide your data and sign an agreement on entering into the register. If your HLA type is compatible with any of the patients, additional testing will be required. Initially, you will need to give your consent, which will be required by law.

Some people are interested in how much donors are paid. In all countries, such activity is “anonymous, free and gratuitous”, so it is impossible to sell stem cells, they can only be donated. Sometimes you can find information with a call to find a donor to help a child with a promise of a reward. In this case, it is possible to sell the material on an individual basis, government agencies do not approve or support such transactions.

Who can be a donor

A potential donor is selected according to one of 4 options. They differ from each other, but they pursue one goal - the maximum degree of compatibility. Suitable for transplant:

Identical twin. As a rule, relatives of this type have 100% compatibility.
Family member. Relatives have a high degree of compatibility with the patient, but this is not necessary. Brothers and sisters have a high probability of becoming a donor.
Not a relative. There is a Russian bone marrow donor bank. Among the donors registered there, there may be people compatible with the patient. There are similar registers in Germany, the USA, Israel and other countries with a developed medical field.

How is bone marrow taken?

Bone marrow sampling is performed in the operating room under general anesthesia to minimize the likelihood of injury and reduce discomfort. A special needle with limiters is inserted into the femur or iliac pelvic bone, where the maximum amount of material needed is. As a rule, repeated punctures are performed to obtain the desired amount of fluid. There is no need to cut the fabric or sew it up. All manipulations are carried out with a needle and syringe.

The required amount of donor bone marrow depends on the size of the patient and the concentration of stem cells in the taken substance. As a rule, 950-2000 ml of a mixture of blood and bone marrow are collected. It seems that this is a large volume, but it is only 2% of the total amount of matter in the human body. Full recovery of this loss will occur in 4 weeks.

Donors are now also being offered the apheresis procedure. To begin with, a person is injected with special drugs that stimulate the release of bone marrow into the blood. The next step is similar to plasma donation. Blood is taken from one arm, and special equipment isolates the stem cells from other components. The fluid cleared from the bone marrow returns to the human body through a vein in the other arm.

How is the transplant

Before the transfer procedure, the patient undergoes an intensive course of chemotherapy, the radical radiation necessary to destroy the diseased bone marrow. After that, pluripotent SCs are transplanted using an intravenous dropper. The procedure usually takes one hour. Once in the bloodstream, donor cells begin to take root. To speed up the process, doctors use drugs that stimulate the work of the hematopoietic organ.

Consequences for the donor

Every person, before becoming a bone marrow donor, wants to know about the consequences of the operation. Doctors note that the risks during the procedure are minimal, more often associated with the individual characteristics of the body's reaction to anesthesia or the introduction of a surgical needle. In rare cases, an infection has been reported at the puncture site. After the procedure, the donor may experience side effects:

pain at the puncture site;
bone pain
nausea;
muscle pain;
increased fatigue;
headache.

Contraindications

Before you become a voluntary bone marrow donor and undergo an examination, you should familiarize yourself with the list of contraindications. They largely intersect with the points on the prohibition of blood donation, for example:

age over 55 or under 18;
tuberculosis;
mental disorders;
hepatitis B, C;
autoimmune diseases;
malaria;
the presence of HIV;
oncological diseases.

Video about bone marrow donation

Reviews

I really wanted to become a donor, but I am terrified of bone punctures and pain. It turned out that you can donate material along with blood. To do this, you need to take the medicine for a while, and the stem cells enter the bloodstream. Next, blood is taken along with him. The procedure lasts longer, but there is no need to pierce the bones and general anesthesia.

Before becoming a bone marrow donor, I was very worried that it would be very painful. I often saw in TV shows how this procedure goes, how much it hurts people. Then it turned out that it was a bone marrow puncture, and its sampling is less painful. When taking medications before the delivery, there was a feeling of fatigue, after the procedure everything went away.

When I was looking for how to become a voluntary bone marrow donor, I did not find information on whether it is possible to refuse already being in the database. As it turns out, you can. If for some reason you are unable to complete the procedure, you can refuse. I have been on the donor register for 2 years now, until I received a call.

How much can you earn with your body in Tyumen: donating blood, sperm and eggs

Blood, plasma and hair are not just mandatory components of any person, but also a way to earn money. We are not talking about millions, of course. But you can get additional income without compromising health. How to become a donor on a charitable basis and what tests you need to pass for this - read below.

Blood and plasma can be donated at the Tyumen regional blood transfusion station at Energetikov, 35.

The station is open from 8:00 to 13:00. You must have your passport with you. Those who donate blood for the first time as a donor will first have to be tested for HIV, hepatitis and syphilis. Two working days after the tests are passed, you can start donating. Of course, provided that your tests are normal.

Before and after donating blood and plasma, you must follow the rules. So, for three days you can not take analgesics and aspirin-containing drugs, as well as:

Do not drink alcohol for 3 days.
After taking antibiotics, 1 month should pass.
You can donate blood 6 months after any surgery.
1 year after acupuncture, tattooing.
2 weeks after vaccination.
1 month after ARI.
Women can come 5 days after the end of menstruation.
One year after childbirth and 3 months after the end of breastfeeding.
2 weeks after tooth extraction.

You need to get a good night's sleep the night before. Dinner should be no later than 8 pm and should not contain fatty, spicy foods. It will be necessary to exclude milk, eggs, mayonnaise, sour cream, fatty cottage cheese, rich soups, dough products, cheese from the diet. If the donor is preparing for plasma transfer, it is necessary to observe the water regime for 3 days, that is, the volume of liquid drunk per day should be at least 2 liters. On the day of blood (plasma) donation, a light breakfast is required. If the donor did not comply with the recommendations, then the fatty plasma is rejected and this procedure is not paid.

How much do they pay for it: in Tyumen, donors for one donation of blood or plasma are paid lunch compensation in the amount of 500 rubles. For one sampling, 450 milliliters of blood is taken from a person.

What are the privileges: if you become an honorary donor (for this you need to donate blood 40 times or plasma 60 times), then you can count on annual payments. This is about 10 thousand rubles a year. In addition, honorary donors have the right to free travel on public transport.

By the way: You can donate blood once every two months. Plasma - twice a week.

According to the curator of the Bone Marrow Donation project, Ekaterina Karakeyan, this is an anonymous, voluntary and free procedure.

The only "bonus" that a donor can receive is a trip to St. Petersburg to collect biological material. Expenses for travel, accommodation and meals, as well as the examination of the donor, are covered by Rusfond. However, it is much cheaper than looking for a donor abroad. After all, the cost of searching for and receiving a transplant from a donor from foreign registries is about 40,000 euros. But often such a search ends in failure (in about 40-50 cases out of 100), this is due to the multinational composition of the Russian population and the great diversity of genes.

More bonuses: in addition to a trip to the cultural capital, the donor receives a complete examination of the body and

high-precision blood typing, which is very expensive.

By the way: To date, only three Tyumen residents have become bone marrow donors, thereby helping to save someone's life. You can join them by voluntarily donating your blood. After that, you will be added to the list of potential donors.

Important: biological material is taken by making a puncture in the pelvic bone, and not in the spine. There are no health implications for the donor. And stem cells are restored after two weeks.

If you are the owner of thick and lush hair, then you can earn money on this. True, in order to get money for hair, it is necessary that they be no shorter than 30 centimeters. Natural colors are more expensive than bleached and dyed ones. And although length is important when selling hair, you will be paid for their weight.

What is the price: In Tyumen, the average price for hair with a length of 30 centimeters starts from 8 thousand per kilogram and above.

In Tyumen, sperm donors are offered to earn 20-25 thousand rubles a month if you work with the medical center on a permanent basis and 1000-1500 rubles for one portion of cryomaterial. But with sperm donation, things are more serious than, for example, with the sale of hair.

First you need to make sure that your biological material is suitable. To do this, in special medical centers, men undergo a spermogram. If the doctors are satisfied with the results, then the sperm is frozen and thawed, after which a series of manipulations are carried out with it to make sure of its quality.

A man fills out a questionnaire, takes a karyotype test, is tested for HIV, hepatitis and syphilis. Only then can he become a donor.

It is recommended to donate sperm no more than once every three days, since donors need sexual rest. Those who work with clinics on an ongoing basis are offered to donate biomaterial even before and after work: this will not take much time, and there are specially designated rooms for all manipulations in medical institutions.

Important: do not forget that a sperm donor not only helps families to have a child, but also becomes a father almost every time he donates cryopreservation. Although everything happens anonymously and the person officially confirms that he will not claim anything, in fact they are half his children. And where and with whom they can live - no one knows.

Women who decide to become egg (oocyte) donors will also have to undergo a series of serious examinations - medical and genetic.

All expenses are covered by the medical center, in return, the woman gives written consent that the eggs and the embryos obtained from them will be the property of the patients. If, according to the indications received, a woman who already has children is suitable as a donor, then the donor oocytes are transferred.

Here, too, everything happens on an anonymous basis. However, as with sperm donation, it is important to remember that the child born to another woman is genetically half yours.

What is the price: for one program, an oocyte donor receives, on average, 60 thousand rubles, regardless of whether fertilization has occurred or not.

Stay on topic:

Tyumen, st. Respubliki, 160/1, 4th floor, office 428

Bone marrow donation in Vologda

Bone marrow donation is painless and completely safe!

Today, all Russian patients who need a bone marrow transplant have to pay about 20,000 euros just for the selection of a donor in a foreign registry.

Its own, Russian bank of bone marrow donors is being created at the R.M. Gorbacheva. It is important that as many people as possible enter this register. In order to become a potential donor, it is enough to donate 5 ml of blood. Then it will be delivered to St. Petersburg for typing.

Blood donation will take place directly at the blood transfusion station in Vologda. If someday the electronic database says that a Vologda resident is suitable for the patient as a donor, he will be contacted.

Anyone between the ages of 18 and 55 who has never had hepatitis B or C or AIDS can become a donor.

You can always get more detailed information in our VKontakte group and on this site.

Questions and answers:

Question: It hurts? I heard that it hurts and you can remain disabled! In Doctor House, they show all this scary, like sticking a needle in the back.

Answer: No, it doesn't hurt. In Doctor House, they often show how they take a spinal cord puncture. This is indeed a dangerous procedure. It has nothing to do with bone marrow donation. The spinal cord and the bone marrow are two different things. Totally different!

Question: Then what is bone marrow?

Answer: Bone marrow is located in the hollow bones of a person. He is responsible for hematopoiesis, for ensuring that there are always red blood cells in the blood - they carry oxygen, platelets that allow blood to clot and white blood cells that protect the body from infections. And also for ensuring that old blood cells are removed from the body on time.

Question: How is bone marrow harvested from a donor?

Answer: There are two options. The choice usually depends on the donor, but in rare cases it is dictated by medical necessity.

In the first case, tiny incisions are made in the pelvic region of the donor under general anesthesia, and then the required amount of bone marrow is taken with a surgical needle. The procedure takes about 30 minutes.
In the second case, a few days before the donation, the donor takes the drug Leikostim, which brings stem cells into the blood. On the day of donation, the donor spends 5-6 hours relatively still. Blood is taken from a vein in one of his arms, passed through a special machine, and returned through a vein in his other arm. At this time, stem cells are taken from the blood.

In the first case, the inconvenience of the donor lies only in his reaction to anesthesia, and in the second, it is time.

Question: What is the risk to the health of the donor itself?

Answer: The risk is associated only with the procedure itself. For example, a reaction to anesthesia, but this happens extremely rarely. A hematopoietic stem cell donor may experience bone pain, muscle pain, nausea, insomnia, and increased fatigue from the drug taken before surgery. The most common side effects are headache and bone pain. These painful sensations disappear immediately after the stem cells are taken. During apheresis, some donors complain of tinnitus due to the use of an anticoagulant to prevent blood clotting. By the way, the youngest bone marrow donor in history was only 11 months old.

Question: Why do people need a bone marrow transplant?

Answer: There are a number of diseases that, until recently, doctors simply did not know how to treat. First of all, it is blood cancer (leukemia), aplastic anemia, autoimmune diseases. The bone marrow in such patients "goes crazy" and begins to produce either a huge amount of immature blood cells, or vice versa, stops working. Aggressive chemotherapy kills all the cells in the bone marrow, so the patient usually needs a transplant.

Question: Every person has relatives, why can't they be donors?

Answer: First of all, doctors are looking for a potential donor among the patient's relatives. The problem is that bone marrow is not blood, it is rather unique. Only 15-20% of patients have a related donor.

Question: Where do unrelated donors come from?

Answer: Many countries around the world have registries of potential donors. In total, more than 20,000,000 people have already become potential donors and have given their consent to enter their data into the donor register. However, about 20 percent of patients do not find a donor.

Question: And what happens to Russian patients?

Answer: For Russian patients - children and adults, a donor is selected in a foreign base. It costs about 20,000 euros. The state does not pay for the selection of a donor, the patient's relatives or funds are looking for this money. Fortunately, Russian doctors know how to perform a bone marrow transplant procedure. And they do it for free.

Question: Why not create a Russian registry then?

Answer: This is exactly what brilliant doctors are doing at the Research Institute of Pediatric Hematology and Transplantology named after R.M. Gorbacheva. A register of donors is already being created there. So far, it has just over 1,000 potential donors. This is very little, but it is already working and saving lives. Potential donors from Vologda will just enter it.

Question: How much do bone marrow donors get paid?

Answer: All over the world, bone marrow donation is always anonymous, free of charge and voluntary. No country in the world pays for such a donation and saving a life. Probably saving a life for a donor is already a big reward. Donorma pay for travel to the place of the procedure, accommodation, meals and compensate for financial losses in the service.

Question: What happens if a donor is found?

Answer: If you qualify as a donor, you will be contacted. Then doctors will conduct tests to study in more detail the compatibility with the recipient. Then you will be explained in detail how the donation procedure will take place, and you will sign the agreement. At this point, you should be absolutely sure of your decision, as the patient at this stage may already be preparing for transplantation and undergoing appropriate procedures.

Question: Who can become a donor, what are the restrictions?

Answer: A person between the ages of 18 and 55 who has never had hepatitis B or C, tuberculosis, malaria, AIDS, cancer, or mental illness. You will take 5 ml. blood from a vein for tissue typing and check everything except the last item. With regard to mental health, a certificate from a mental health clinic will not be required.

Question: So what will happen in Vologda, how to become a donor?

Answer: To become a potential donor, you need to donate 5 ml of blood. Her collection will be organized at the blood transfusion station in Vologda. Then it will be urgently delivered to St. Petersburg, where it will be typed and all Vologda donors will be included in the Russian registry.

Recently I received a message from my former student Olya: “Yulia Markovna, good afternoon. I wanted to thank you for that bone marrow donation campaign in the 5th year. I forgot about this episode. But it so happened that three years later they contacted me. And a couple of days ago I returned from St. Petersburg.

Residents of Vologda will be able to enter the Russian database of bone marrow donors

The Good People Charitable Foundation is preparing an action during which any resident of Vologda will be able to enter the All-Russian Bone Marrow Donor Bank of the Research Institute named after R.M. Gorbacheva. During its existence, the Good People Foundation has repeatedly announced a fundraiser for the selection of a bone marrow donor for its wards. There are a number of deadly diseases for which bone marrow transplantation is the only way to combat the disease. Russian doctors have long learned how to carry it out and do it for free. But the dangerous, time-consuming procedure is sometimes not the most difficult on the road to recovery. The fact is that today Russia does not have its own bank of bone marrow donors.

bone marrow donation

Bone marrow is a special tissue of soft consistency, which is located in the cavity of the pelvic bones and ribs, and it is also found, in the smallest amount, in the tubular bones and inside the vertebrae. This is an important part of the body, responsible for immunity and hematopoiesis. It is thanks to him that a constant replenishment of the arsenal of blood cells that are involved in immune reactions is possible. In addition, it is the only depot of stem cells in the human body.

When do you need a bone marrow transplant?

It contains many young, immature and undifferentiated cells that do not have specialization. These cells are clean sheets, the common precursors of all cells in the body. Due to the high importance of the bone marrow, it has such a great value in the human body. His transplantation can save lives. First of all, it is used to treat patients with;

Leukemia;
Neuroblastomas;
Tumors of the lymphatic system;
aplastic anemia;
Many genetic defects of the circulatory system.

A bone marrow transplant does not mean that the donor's whole brain is removed and given to the recipient - a person who needs it. The transplant itself involves the intravenous administration of bone marrow stem cells from the donor to the recipient. This allows you to restore the undermined hematopoietic system of the patient. Affected by the disease and the combination of high doses of drugs with radiation therapy, the blood system is significantly depressed and does not have the ability to recover on its own without outside help.

As a result, a person who has, in the case of leukemia, a lack of hematopoietic cells, has new normal cells that have developed from donor stem cells. The method of bone marrow transplantation, abbreviated as TCM, has found application in Russia relatively recently. So, it began to be used only in 1990.

Often, TCM is the only way to save human life. This method undoubtedly carries serious risks in the form of acute immune reactions of rejection, in the case of the perception of the bone marrow by the recipient's body as a stranger that needs to be removed. But the benefits outweigh the risks. That is why TCM is so valued in the world of white coats.

There are two main forms of bone marrow transplantation - allogeneic and autologous. Each of them has its own characteristics:

The concept of allogeneic transplantation is often understood as taking bone marrow from a relative or from a person who genetically matches the recipient as closely as possible. Such a transplant can be syngeneic, that is, produced from a twin. Or maybe from a healthy relative. The most preferred is a complete 100% match between the relative and the patient. The lower the percentage, the higher the risk of rejection. If the donor is not a relative, such a transplant is called haploidentical. This kind of transplant usually offers a 50% match and often ends badly;
An autologous transplant involves the transplantation of pre-harvested healthy stem cells that have been frozen. These cells are transplanted into the patient after aggressive chemotherapy. A successful transplant provides the patient with a rapid recovery of the immune system, as a result of which the formation of blood is normalized. Such transplantation is used during the remission of the disease or in the case of isolation of the pathological process from the bone marrow, with brain tumors, neoplasms of the ovaries or mammary glands.

How do people become bone marrow donors?

A donor is a person who shares his bone marrow cells with someone in need. Donors can be:

The patient himself;
Close relatives;
Not relatives who are genetically close.

It is impossible to imagine a better effect than the transplantation of one's own bone marrow, since an immunological conflict cannot arise in this case, because one's own tissues are transplanted. However, this method is possible only in the absence of damage from the bone marrow. In such cases, stem cells are taken in advance and injected back after intensive irradiation.

Good results are achieved with bone marrow transplantation of relatives. Most often, the patient's brother or sister is the ideal bone marrow donor, but mom or dad is often much less compatible. A stranger, who at the cellular level coincides with the patient, can also become a suitable donor. It is possible to determine this compatibility with the help of special typing tests. This involves a blood test to determine the genes responsible for the compatibility of two people. Finding such a donor is possible thanks to special registers.

The registries represent an extensive database of potential bone marrow donors. They began to form at the end of the 20th century in Europe and the USA. To date, the network has grown so much that the US national registry has a base of 9 million donors, and one of the German registries has about 5 million. There is also an international global registry IBMTR, which combines information on 20 million donors. In Russia, these figures are much more modest. There are currently data on approximately 50,000 donors.

However, the registry search is not a free procedure. The selection of donors in the International Registry requires about 21 thousand euros, while in Russia the search is usually paid for by such charitable foundations as Rusfond and Podari Zhizn. Absolutely everyone can become a bone marrow donor if:

Is in the age range from 18 to 50 years;
Not ill with hepatitis B and C, tuberculosis, malaria, HIV;
Not having cancer or diabetes.

About 9 ml of blood is taken from all willing volunteers for typing analysis. They sign an agreement on entry into the register. The Rusfond website provides a list of stations where it is possible to donate blood in order to become one of the donors of the National Register. Russia conducts BMT only in a few medical institutions in Moscow, St. Petersburg, Yekaterinburg, Chelyabinsk, Sverdlovsk. Free therapy is available to a few, since only a small number of quotas are allocated for this.

Thus, in the Children's Institute of Hematology and Transplantology in St. Petersburg, in 2013, 256 quota procedures and about 10 paid procedures were performed. In Sverdlovsk in 2015, no more than 30 BMT were performed among adults. The Podari Zhizn charitable foundation publishes disappointing statistics, which says that about 1,000 children need a new bone marrow in Russia every year. Not including adults.

Getting treatment for money is not the most economical procedure. Thus, one bed-day spent in a specialized transplantation department at the Rogachev Institute will cost at least 38,500 rubles. The maximum prices fall on Moscow and St. Petersburg, where the cost can reach up to 2-3 million rubles. Treatment abroad will cost even more. Treatment of patients in Germany costs about 200 thousand euros, while Israel treats such patients for 250 thousand dollars.

Bone marrow donation procedure

The manipulation of bone marrow donation itself is much simpler than surgery, although it is performed in the operating room under general anesthesia or under epidural anesthesia. This is necessary in order to minimize the possibility of injury and eliminate discomfort from the procedure. The sampling is carried out using a special needle and syringe. So, the needle is inserted into the femoral or iliac pelvic bones, since there is the highest concentration of bone marrow.

Re-insertion of the needle may often be required to obtain the correct amount of material. There is no need to cut the bone and sew it up later, because a special needle can penetrate the thickness of the bone. Most often, about 1000-2000 ml of a mixture of blood and bone marrow is taken. It seems that this is a large number, however, it is only 2% of the human body in general. The volume lost will be fully replenished in 4 weeks.

To avoid the donor losing their blood along with the bone marrow, the apheresis procedure was created. It consists in the introduction of a special drug before manipulation. It stimulates increased production of bone marrow into the blood, and then blood is taken through the vein of one arm. It is filtered by a special apparatus that isolates the necessary stem cells from the rest of the blood. As a result, the remaining blood, purified from the components of the bone marrow, is again returned to the human body through the vein of the other arm.

Although the risk involved in the procedure is minimal, each donor should be warned of the possible consequences. Complications, if any, are usually associated with:

The individual reaction of the body to the introduction of an anesthetic or anesthesia;
Incorrect insertion of the needle;
The introduction of infection into the puncture site with a needle.

After the manipulation, a person may feel negative feelings in the form of:

Pain at the needle entry site;
Pain in the musculoskeletal system;
nausea;
Increased fatigue;
Headache.

Donation of bone marrow does not go unnoticed for a person. Yes, he will experience discomfort that will last for several days. Perhaps he will be exposed to minimal risk, however, is this the price for saving a life? Donor become at the call of the heart. This is a great service and help, this is goodness in its purest form.

Video

I will become a BONE MARROW doron for MONEY I really need help financial difficulties I have a 3 year old child my husband left when the child was 7 months old I do not work while my mother helps in any way I can rent a room very difficult to ask for help MY TEL NO 89774449047

I will become a bone marrow donor for money. I have financial problems and need help. Write to e-mail or phone 89376491556

I will become a bone marrow donor for money. I am alone with two children.

I will become a bone marrow donor for money. need money due to financial difficulties write to the mail [email protected]

The patient himself. His disease must be in remission or not affect the bone marrow itself. The resulting stem cells are carefully processed and frozen.

I will become a bone marrow donor for money write to e-mail [email protected]

I want to help my children, I’m ready to become a donor for money, I’m 40 years old, I only had childhood diseases, my blood type is positive, I didn’t have any operations, I seem to be healthy, write to anyone who needs help, but unfortunately only for money ...

I will become a bone marrow donor for a fee, 34 years old, completely healthy.

Write whatsvp\viber +79110381714

I am in Petersburg.

I will become a bone marrow donor for money. I am 32 healthy. Write 89680054146

Features of stem cell collection from a donor and consequences after the procedure

Bone marrow donation is a fairly popular procedure in modern medicine, which is used by people who need a specific organ transplant. There are a lot of such people: from the smallest to the elderly. For example, when developing leukemia or another similar disease, a bone marrow transplant is required, and for this procedure it is necessary to find a donor. Who can become one and, most importantly, are there any consequences of bone marrow sampling?

Who can apply to be a donor?

What is a "bone marrow donor"? This concept refers to a person who, through a fence in a stationary setting, gives a small part of his bone substance for subsequent administration to another person. Such a semi-liquid substance is localized in the bones of the body and ensures the production of blood cells. This is necessary for transplantation from a healthy to a sick person in the event of the development of leukemia, tumors, aplastic anemia, genetic ailments.

How to become a bone marrow donor? Special registers of applicants for donation are being created, which can be entered by every healthy person by signing a special agreement. The age of a potential donor is limited: from 18-50 years.

After a person has been entered into the register, it will be necessary to wait until his bone substance is needed for transplantation. It is possible to determine whether the substance of a particular person is suitable in case of a disease of another, by comparing the combinations of genes after taking the biomaterial from a potential donor and the patient. After confirmation of compatibility, a person must finally decide whether he is ready to be a donor.

In some cases, the donor may refuse to perform such a surgical intervention, even if he is suitable for such a procedure in all respects. This may be due to some weighty reasons, for example, poor general health at the time of the need for sampling, lack of time on the day of the operation, fear of possible complications or pain that may arise.

Bone marrow donation is a voluntary procedure. That is why a person who has agreed to hold it in the future can refuse it at any time. But the donor must understand that by his refusal he puts someone's life on the line.

How much do they pay for donating bone marrow? This procedure is considered free of charge and anonymous in each country.

Under what circumstances is a person not suitable for donation?

Contraindications for bone marrow donation can be either absolute or relative. The absolute ones are:

Temporary contraindications with a period of prohibition on taking the substance after recovery include the following:

blood transfusion - 6 months;
surgical interventions, including artificial termination of pregnancy - from six months;
tattoo - procedure, acupuncture treatment - a year;
development of malaria - three years;
development of acute respiratory infection - a month;
inflammatory process in the body of an acute or chronic course - a month;
development of VVD (vegeto - vascular dystonia) - a month;
some vaccinations - from ten days (vaccination against hepatitis B, tetanus, diphtheria, cholera) to a month (vaccination against plague, tetanus, rabies);
pregnancy period - a year after childbirth;
monthly - five days after the end.

Bone marrow transplantation is a complex procedure, the outcome of which is almost never completely unclear. After all, even material taken from a relative and suitable in many respects may not take root. And then you have to start all over again. Moreover, unlike finding a suitable donor in this matter is much more difficult, because. the connection between the tissues of the patient and a potential donor (especially a random person) is often incompatible.

Doctors say that in order to find the most ideal donor, it is necessary to check several thousand, or even tens of thousands of people for compatibility.

At the same time, all examined donors are entered into a special database of future donors, in which they can be found if necessary.

Contraindications for bone marrow donation

Before you go for a bone marrow examination, carefully read the information on contraindications. So, a person who has a history of hepatitis B or C, tuberculosis, malaria, malignant tumors (even if they are treated), mental disorders, and HIV infection cannot become bone marrow.

Also, they will not take into the database donors suffering from autoimmune diseases, having problems with the respiratory system and the cardiovascular system. It will not be possible to give materials to those who have intolerance.

Ideally, a person aged 18 to 55 can become a donor, preferably without bad habits and chronic diseases. Only such a type will easily endure apheresis (i.e., the removal of part of the blood or bone marrow).

Naturally, if we are talking about a critical and hopeless situation, anyone who has any mild chronic diseases can become a donor. The remaining contraindications will remain, even if there is no way out at all.

How to become a donor

To start you will need blood. Your samples will be taken for analysis and will determine the genes, antibodies and other components that may be important in the selection of a donor for a particular component. This is called HLA typing.

Once you pass this test, you will be asked to fill out a questionnaire, an agreement to include you in the register of potential donors, and a full one will be carried out to confirm that you are healthy.

Remember that participation in the bone marrow transplant procedure is voluntary. And you can always refuse, inclusion in the registry does not oblige you to go all the way. But just remember that if you agreed, you can suddenly refuse to participate in no later than 10 days before the appointed date.

True, in this case, it is worth considering the psychological state of the patient, to whom you have already given hope for a donor bone marrow, and then taken away.

Bone marrow is a soft, spongy tissue found inside bones. Bone marrow contains hematopoietic or hematopoietic stem cells.

Hematopoietic stem cells can divide to create more hematopoietic stem cells or develop to create red blood cells - erythrocytes, white blood cells - leukocytes and platelets, which are responsible for blood clotting. Most hematopoietic stem cells are found in the bone marrow, although a small number are found in the umbilical cord and blood.

Cells obtained from any of the above locations can be used for transplantation.

What is a bone marrow transplant?

Bone marrow and peripheral blood stem cell transplantation is used to treat damaged stem cells using high doses of chemotherapy and/or radiation therapy.

There are three types of transplant:

Autologous transplantation - transplantation of the patient's own stem cells;

Syngeneic transplantation - the transplant is transferred from one monozygotic twin to another;

Allogeneic transplant - the transplant is taken from the patient's sibling or parent. A person who is not a relative, but is suitable for transplantation according to certain parameters, can also act as a donor.

How is a bone marrow transplant performed?

When transplanting from the patient's own body, of course, thorough treatment is required. For this reason, first, in accordance with the plan approved by the doctors, treatment will be carried out. At the next stage, stem cells will be collected, followed by freezing and treatment with special medicines. The dose of medication in such patients is higher. Usually, within a week after the collection of healthy stem cells, the patient receives high-dose drug therapy. At the end of the treatment, the patient receives healthy latent stem cells back. Thanks to this approach, stem cells, cells that were damaged during treatment, begin to repair themselves.

What are the risks of autologous transplantation?

Taking stem cells from a patient carries the risk of taking infected cells. In other words, the administration of frozen stem cells to a patient may result in a relapse of the disease due to the administration of diseased cells.

What are the risks of allogeneic transplantation?

During allogeneic transplantation, there is an exchange between the immune systems of the donor and the patient, which is an advantage. However, when performing such a transplant, there is a risk of a mismatch of immune systems. The donor's immune system can have a negative impact on the recipient's body. There is a risk of damage to the liver, skin, bone marrow and intestines. This process is called the graft-versus-host reaction. If such a reaction occurs, patients require treatment, since lesions can cause malfunctions or organ failure. With autologous transplantation, these risks are absent.

How is it determined that the donor's stem cells are compatible with the recipient's stem cells in allogeneic and syngeneic transplantation?

During transplantation, doctors use donor stem cells that match the patient's stem cells as much as possible. This is done to reduce side effects. Different people have different types of protein filaments on the surface of their cells. Such protein filaments are called human leukocyte antigen (HLA). Thanks to a blood test - HLA typing - these protein filaments are deciphered.

In most cases, the success of allogeneic transplantation depends on the degree of compatibility of the HLA antigens of the donor and recipient stem cells. The probability of accepting the donor's stem cells by the recipient's body increases with an increase in the number of compatible HLA antigens. Generally speaking, if there is a high degree of compatibility between donor and recipient stem cells, the risk of developing a complication called graft-versus-host disease (GVHD) is reduced.

The likelihood of HLA compatibility of close relatives and especially siblings is higher compared to HLA compatibility of people who are not relatives. However, only 20-25% of patients have an HLA-compatible sibling or sister. The probability of having HLA-compatible stem cells in an unrelated donor is slightly higher and is about 50%. HLA compatibility among unrelated donors increases significantly if the donor and recipient come from the same ethnic group and belong to the same race. While the number of donors is generally on the rise, some ethnic groups and races find it more difficult than others to find a suitable donor. A universal record of volunteer donors can help in finding an unrelated donor.

Monozygotic twins have the same genes and therefore the same strands of HLA antigens. As a result, the patient's body will accept the transplant of his/her monozygotic twin. However, the number of monozygotic twins is not very high, so syngeneic transplants are rarely performed.

How is bone marrow obtained for transplantation?

The stem cells used in bone marrow transplants are obtained from the fluid found inside the bones - the bone marrow. The procedure for obtaining bone marrow is called bone marrow harvesting and is the same for all three types of transplants (autologous, allogeneic, and syngeneic). A patient under general or local (expressed in numbness of the lower body) anesthesia is inserted into the pelvic bone with a needle for bone marrow sampling. The bone marrow harvesting process takes about an hour.

The resulting bone marrow is processed to remove residual bone and blood. Antiseptics are sometimes added to the bone marrow, after which it is frozen until stem cells are needed. This method is called cryopreservation. Thanks to this method, stem cells can be stored for many years.

How are peripheral blood stem cells obtained?

Peripheral blood stem cells are obtained from the bloodstream. Peripheral blood stem cells for transplantation are obtained through a procedure called apheresis or leukapheresis. 4-5 days before the apheresis, the donor receives a special drug that increases the number of stem cells in the bloodstream. Blood for apheresis is taken from a large vein in the arm or using a central venous catheter (a soft tube placed in a wide vein in the neck, chest, or pelvic area). Blood is taken under pressure using a special machine that collects stem cells. Then the blood is injected back to the donor, and the collected cells are taken away for storage. Apheresis usually takes 4 to 6 hours. The stem cells are then frozen.

Are there any risks for bone marrow donors?

Usually, donors do not have health problems, since a very small amount of bone marrow is taken. The main risk for the donor is the possibility of complications after anesthesia.

For several days, there may be swelling and compaction at the sampling sites. During this period, the donor may feel a sense of fatigue. Within a few weeks, the donor's body will restore the lost bone marrow, however, the recovery period is different for each person. While some people need 2-3 days to return to daily activities, others may need 3-4 weeks to recuperate.

Are there any risks for peripheral blood stem cell donors?

Apheresis usually causes minimal discomfort. The donor may experience weakness, trembling, numbness of the lips, and cramps in the arms. Unlike bone marrow sampling, anesthesia is not required for peripheral blood stem cell sampling. A drug used to release stem cells from bones into the bloodstream may cause bone and muscle pain, headaches, fatigue, nausea, vomiting, and/or trouble sleeping. Side effects recede 2-3 days after taking the last dose of the drug.

What happens after a stem cell transplant to a patient?

Once introduced into the bloodstream, the stem cells will settle in the bone marrow, where they will begin to produce red and white blood cells and platelets. These cells usually start producing blood within 2-4 weeks after transplantation. Doctors will monitor this process with frequent blood tests. Full recovery of the immune system, however, will take much longer. This period usually takes several months for autologous transplantation and up to 1-2 years for allogeneic and syngeneic transplants.

What are the possible side effects of a bone marrow transplant?

The main risk of treatment is increased susceptibility to infections and bleeding associated with high-dose cancer treatment. Doctors may prescribe antibiotics to patients to prevent or treat infections. A platelet transfusion may be needed to prevent bleeding, and a red blood cell transfusion may be needed to treat anemia. Patients undergoing bone marrow or peripheral blood stem cell transplantation may experience short-term side effects such as nausea, vomiting, fatigue, loss of appetite, mouth ulcers, hair loss, and skin reactions.

Possible long-term side effects usually include reactions associated with pre-transplant chemotherapy and radiation therapy. These include infertility (the biological inability of the body to conceive), cataracts (clouding of the crystal of the eye), secondary cancer, and damage to the liver, kidneys, lungs, and/or heart. The risk of complications and their severity depend on the patient's treatment and should be discussed with the doctor.

What is a "mini transplant"?

A mini-transplant is a type of allogeneic transplant (low-intensity or non-myeloblast transplants). To date, this approach is being investigated clinically and is aimed at treating various forms of cancer, including leukemia, multiple myeloma, and other forms of blood cancer.

In a mini-transplant, less intensive, low-dose chemotherapy and/or radiation therapy is used to prepare the patient for an allogeneic transplant. The use of small doses of anti-cancer drugs and radiation only partially destroys the bone marrow, and does not damage it completely, and also reduces pure cancer cells and suppresses the immune system in order to prevent transplant rejection.

Unlike traditional bone marrow or peripheral blood stem cell transplantation, after mini-transplantation, both donor and recipient cells continue to exist for some time. When the bone marrow begins to produce blood, the donor's cells enter into a graft-versus-tumor reaction and begin to destroy the cancer cells left behind by anti-cancer drugs and/or radiation therapy. To increase the graft-versus-tumor effect, donor white blood cells may be injected into the patient. This procedure is called “donor lymphocyte infusion”.

By caring and maintaining your health, you can help those who are deprived of health. So, one option is to register in the bone marrow donor registry and possibly save someone's life.
Donation in Russia, as well as throughout the world, is voluntary. No one can force a person, but, unfortunately, not everyone can fit this role.

Requirements for candidates:

Age group 18-50 years old;
the person has not been ill and is not ill with hepatitis B and C, tuberculosis, malaria, HIV, cancer or diabetes.

You are encouraged to inform the donor registry staff of any change in your phone number or address.

Before bone marrow sampling, it is necessary to undergo a laboratory blood test to determine the HLA phenotype (you need to undergo typing). Without consent, doctors are not entitled to enter a candidate into the register; it is necessary to personally sign a form with consent to enter personal data into the register.

If a patient needs a transplant, the same study is performed. Based on the results obtained, a candidate suitable for matching the genotype is selected. The coincidence of compatibility genes is possible not only in relatives, but also in completely unfamiliar people living far from each other.

How bone marrow is taken from a donor and how the transplantation takes place

There are several types of transplantation. Each of them has its own advantages and disadvantages. The method is selected based on the type of patient's disease and the selected clinic. Experts from different countries consider different methods of transplantation to be the most acceptable. The process of transplantation itself, regardless of the species, is largely similar.

A transplant always carries the risk of rejection of foreign cells by the cells of the body. That is why the process of careful selection of a suitable donor is so important. When the necessary option is determined, the patient begins to prepare for the operation.
First of all, based on the results of numerous studies, the physical condition of the patient and his ability to endure the transplant procedure are assessed.

Chemotherapy is required. This is necessary to destroy the affected elements in the bone marrow. If the cells of the patient will be used for transplantation, then the tissue is taken before chemotherapy. After that, the material undergoes purification and is used for transplantation after a course of irradiation.

A few days later, a catheter is placed in the patient's neck. Healthy cells and all the necessary medicines will be injected through it.
The most difficult period comes when the patient begins to adapt to the injected cells. They, getting into the bones, begin to divide and take root. The adaptation process can take from 2 weeks to a month. During this period, there is a risk of rejection of foreign cells. For this reason, the patient is always only in the hospital under the round-the-clock supervision of specialists. The ward is kept sterile, the patient receives blood transfusions. Antibiotics and medications are prescribed to reduce the risk of rejection of the injected cells.

How much does bone marrow cost and how much is a donor paid
Donation worldwide is not paid. The reward for being sensitive to those in need is saving lives and preserving human health.
The transplantation procedure in Russia is carried out free of charge due to the allocation of state quotas. Unfortunately, the number of quotas is limited! The price for a paid procedure is different:
in Moscow the price reaches 3 million rubles.
in St. Petersburg - up to 2 million rubles.
Such amounts are justified by the complexity of the procedure and the cost of the necessary drugs.

In Russia, no fee is charged for the selection of a donor from a registry operating on the territory of the Russian Federation. This cost is covered by the charitable foundation. If it is necessary to find a donor in foreign registries, the patient will be billed for 21,000 euros. The bill for the transplant and all the necessary manipulations after it is billed separately.
Possible consequences of a transplant for a donor
The donor does not face any consequences from the donation of bone marrow, the material is taken only within the permissible limits, and tissue restoration takes place over a period of no more than 1 month. There may be a risk of deterioration during or after the manipulation. But this risk is associated with a reaction to anesthesia.

If it is known about intolerance to anesthesia, it is necessary to discuss this in advance with a specialist preparing for the procedure. Sometimes there is a feeling of tinnitus during the procedure, headache or bone pain, but all this disappears after the material is taken.
Where to become a bone marrow donor in St. Petersburg
A complete list of points conducting blood sampling for typing can be found on the Rusfond website.
It also contains contacts of employees who can be contacted if your region is not in the list of those indicated.

Centers conducting BMT in St. Petersburg:

Gorbacheva Research Institute of Pediatric Oncology, Hematology and Transplantation
st. Leo Tolstoy, 6−8 http://www.spb-gmu.ru/

Russian Research Institute of Hematology and Transfusiology
2nd Sovetskaya st., 16 http://www.bloodscience.ru/

Bone marrow donation in Moscow

Institute of Pediatric Oncology and Hematology, Blokhin Russian Cancer Research Center
Moscow, Kashirskoe sh., 24
ronc.ru

Hematological Research Center (SSC) of the Ministry of Health of the Russian Federation
Moscow, New Zykovsky pr-d, 4a